双歧三联活菌胶囊联合莫沙必利对IBS-C重叠FD患者血清胃肠神经递质的影响

Influence of triple viable bifid capsules combined with mosapride on serum levels of gastrointestinal tract neurotransmitters in patients with constipation-predominant irritable bowel syndrome overlapping functional dyspepsia

目的探讨双歧三联活菌胶囊联合莫沙必利对便秘型肠易激综合征(IBS-C)重叠功能性消化不良(FD)患者的疗效及其对血清胃肠神经递质水平的影响。方法选择IBS-C重叠FD患者84例,随机分为观察组和对照组,每组42例。两组患者均予以莫沙必利片5mg/次,3次/d,餐前约30min口服。观察组患者在对照组基础上加用双歧三联活菌胶囊630mg/次,3次/d,餐后约30min温水服用。两组患者均治疗8周。观察并比较血清胃肠神经递质[胃动素(MTL)、P物质(SP)和生长抑素(SS)]水平的变化,并评估其临床疗效及患者不良反应。结果治疗8周后,两组患者血清MTL和SP水平显著上升,SS水平显著下降,且观察组患者指标变化比对照组更明显,差异均有统计学意义(P<0.05);同时观察组患者临床总有效率高于对照组(χ2=4.09,P<0.05)。观察组和对照组患者分别出现不良反应4例与6例,均为腹泻,症状较轻微,两组差异无统计学意义(χ2=0.45,P>0.05)。结论双歧三联活菌胶囊联合莫沙必利治疗IBS-C重叠FD疗效显著,安全性较高,能纠正患者胃肠神经递质分泌异常,上调血清MTL和SP水平,下调血清SS水平,有效促进胃肠动力。

Objective To discuss the influence and efficacy of triple viable bifid capsules combined with mosapride on serum levels of gastrointestinal tract neurotransmitters in patients with constipation-predominant irritable bowel syndrome（IBS-C）overlapping functional dyspepsia（FD）.Methods 84 cases of IBS-C overlapping FD were selected and divided into observation group or control group,with 42 cases in each group.All the patients were given mosapride 5 mg tid orally 30 minutes before meal,while the patients in observation group were additionally given triple viable bifid capsules 630 mg tid 30 minutes after meal,for 8 weeks.The changes of serum levels of gastrointestinal tract neurotransmitters including motilin（MTL）,substance P（SP）and somatostatin（SS）were observed and compared between groups,and the clinical efficacy was evaluated.Results After 8 weeks of treatment,the serum levels of MTL and SP in both groups were obviously higher,while the levels of SS obviously lower（P0.05 or P0.01）;the changes were more significant in observation group than in control group（P0.05）.The total clinical efficiency rate in observation group was much higher than that in control group（χ2=4.09,P0.05）.4 and 6 cases of untoward effect appeared in observation group and control group respectively,all of which were mild diarrhea.No obvious statistical differences were observed between the two groups（χ2=0.45,P0.05）.Conclusion Triple viable bifid capsules combined with mosapride has reliable efficacy on IBS-C overlapping FD with high safety,which can adjust abnormal secretion of gastrointestinal tract neurotransmitters,upregulate the serum levels of MTL and SP,while downregulate the serum level of SS,and improve gastrointestinal motility.